Retirees remain confused about Medicare changes

A year after the most sweeping changes in Medicare history became law, many retirees remain confused, and health plans say critical details about benefits and cost have yet to be decided.

The federal Medicare Modernization Act provides some prescription drug coverage to older adults and people with disabilities who are enrolled in Medicare. It also increases the role of private health insurance plans in the system and puts more emphasis on managing the chronic diseases that plague millions of Medicare beneficiaries.

But success largely depends on Medicare enrollees' willingness to join private plans and on whether those plans continue to offer coverage in future years, experts say.

The plans are not standardized, which forces people to sort through a maze of benefits and cost structures, said Edward Lawlor, a Medicare expert and dean of the George Warren Brown School of Social Work at Washington University.

"There is still quite a bit of chaos on both the beneficiaries' side - the people who are going to be receiving Medicare benefits - and on the providers' side," Lawlor said. "There are just going to be rounds and rounds of changes, and that by itself is going to create a lot of confusion."

The law, signed a year ago this week, is being phased in. Discount drug cards offered by pharmacies, insurers and other private groups are available until 2006, when the full benefit takes effect. Older adults can choose whether to enroll in a range of plans offering prescription coverage. Some plans also will offer expanded health benefits.

Surveys find that many retirees still don't understand how the revised benefit will work; others are concerned that the number and variety of choices will be overwhelming.

•	Retirees remain confused about Medicare changes St. Louis Post-Dispatch, Friday, Dec. 10, 2004 Byline: Mary Jo Feldstein, of the Post-Dispatch